USPSTF: Vitamins no help in CVD, CA prevention

USPSTF: Vitamins no help in CVD, CA prevention
USPSTF: Vitamins no help in CVD, CA prevention

HealthDay News -- There is currently not enough evidence to recommend for or against using multivitamin supplements for the primary prevention of cardiovascular disease (CVD) or cancer, the U.S. Preventive Services Task Force (USPSTF) has stated in a draft recommendation.

In it's first update on the topic since 2003, the task force reaffirmed a recommendation against using beta-carotene supplements, specifically, for CVD or cancer prevention due clear evidence of a lack of benefit and an increased for for lung cancer among those already at risk for the disease.

The draft guidelines also include one change from the earlier version -- there is now enough evidence to advise against using vitamin E to protect against CVD or cancer due to lack of benefit, USPSTF determined.

"There is not enough evidence to determine whether you can reduce your risk of CVD or cancer by taking single or paired nutrients, or a multivitamin," Task force co-chair Michael LeFevre, MD, MSPH, said in a press release.

The proposed guidelines are on part with those of other organizations including the National Institutes of Health, the Academy of Nutrition and Dietetics and the American Heart Association, which have also found insufficient evidence to recommend multivitamin use for chronic disease prevention.

Nearly half of U.S. adults reported using at least one dietary supplement from 2007 to 2010, spending an estimated $28.1 billion on dietary supplements in 2010 alone according to the task force.

To reassess evidence that's become available since the 2003 recommendations, Stephen P. Fortmann, MD, from the Kaiser Permanente Center for Health Research in Portland, Ore., and colleagues reviewed 103 articles that met inclusion criteria, including 26 studies. The results were published in Annals of Internal Medicine.

Supplements assessed in the latest draft recommendations included vitamin D, calcium, selenium and folic acid -- a wider range than those analyzed in 2003, which focused primarily on studies assessing vitamins A, C and E, as well as multivitamins with folic acid and antioxidant combinations.

In the two largest trials, involving 27,658 individuals, men taking a multivitamin for more than 10 years had lower cancer incidence (pooled unadjusted relative risk, 0.94; 95% CI: 0.89 to 1.00); however, no effect was seen in women.

High-quality studies of single or paired nutrients were scant and heterogeneous, and results yielded no clear evidence of benefit or harm, Fortmann and colleagues determined.

"Based on these findings, the USPSTF cannot recommend for or against taking vitamins or minerals alone, in pairs, or as a multivitamin to prevent CVD or cancer," the task force wrote, adding that future studies should be "more representative of the general population, include women and minority groups and have enough power to demonstrate whether there are true subgroup differences."

The recommendation statement has been posted for public comment through Dec. 9, 2013.

References

  1. Fortmann S et al. Ann Intern Med. 2013; doi:10.7326/0003-4819-159-12-201312170-00729.
  2. U.S. Preventive Services Task Force. Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Draft Recommendation Statement. AHRQ Publication No. 14-05199-EF-2. http://www.uspreventiveservicestaskforce.org/draftrec2.htm
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